The man in fertility treatment
At Diers the man is not just on the side line. Learn more about your role going through fertility treatment.
The man’s role is important
When we talk about fertility treatment, the focus is very often on the woman’s cycle, ovulation, hormones and treatment timing. But the man also plays an important role.
Sperm quality has an impact on the chance of pregnancy – both in natural conception, insemination, IVF and ICSI. It therefore makes good sense to examine and support male fertility as a natural part of the process.
At Diers, we meet many men who want to do the right thing, but who are unsure what they can actually do themselves. This page is for you if you would like to better understand your role, improve your chances and get an overview of the examinations available.
Opportunities
Reduced sperm quality is common and can have many different causes. Sometimes a clear explanation is found, and sometimes it is not. Most importantly, a semen sample and, if relevant, further assessment can provide important information about which treatment makes the most sense.
For some couples, insemination is the right place to start. For others, IVF or ICSI may offer better chances. In some cases, it may also be relevant to investigate whether there is an underlying cause of the reduced sperm quality that can be treated or improved.
What can affect sperm quality?
Sperm quality can vary from sample to sample and may be affected by lifestyle, illness, medication, temperature and hormonal factors.
Factors that may play a role include:
- smoking, snus, e-cigarettes and cannabis
- alcohol consumption
- being overweight or underweight
- anabolic steroids or performance-enhancing substances
- fever or illness in recent months
- heat around the testicles, for example sauna, hot baths or very tight clothing
- certain types of medication
- stress, sleep and general health
- previous infections, such as chlamydia
- previous surgery, injuries or diseases affecting the testicles
This does not mean that one single factor necessarily explains everything. But it does mean that there are often things you can do yourself to support sperm production.
How you can support your sperm quality yourself
Sperm cells are formed over a period of approximately three months. This means that lifestyle changes can take time before they are reflected in a semen sample. Still, it is worth getting started straight away.
Stop using nicotine and cannabis
Smoking, snus, e-cigarettes and cannabis can affect the number, motility and quality of sperm cells. If you smoke or use nicotine products, stopping is one of the most important things you can do for your fertility.
Keep alcohol at a low level
High alcohol consumption can affect both hormones and sperm quality. We recommend staying within the official health authority guidelines – and preferably below them while you are trying to achieve pregnancy.
Avoid anabolic steroids
Anabolic steroids can, in some cases, reduce or completely stop sperm production. This also applies even if the body otherwise feels strong and healthy. If you have previously used or are currently using anabolic steroids, it is important to mention this as part of the fertility assessment.
Maintain a healthy weight
Both being overweight and underweight can affect sperm quality. Stable blood sugar, regular exercise and a healthy, varied diet can support both hormonal balance and sperm production.
Avoid too much heat around the testicles
Sperm production works best at a slightly lower temperature than the rest of the body. It may therefore be a good idea to limit sauna use, very hot baths, tight clothing and prolonged use of a laptop directly on your lap.
Stay active – but avoid overtraining
Regular exercise is good for the body, hormones and fertility. Very extreme training or the use of performance-enhancing substances, however, may have a negative effect.
Prioritise sleep and recovery
Fertility is closely connected to the body’s general health. Sleep, recovery and stress levels can therefore also play a role. You do not have to live perfectly – but supporting your body as well as possible can make a difference.
Semen analysis
A semen analysis is often the first and most important step when assessing male fertility.
A semen analysis looks at, among other things:
- the volume of semen
- the concentration of sperm cells
- the total number of sperm cells
- sperm motility
- sperm morphology
- possible signs of inflammation or other findings
A semen sample provides important information about which treatment best matches your situation, if treatment is needed.
If sperm quality is mildly to moderately reduced, insemination may often be enough. If sperm quality is more severely reduced, IVF or ICSI may be a better option.
Possible examinations for the man
Depending on the semen sample and medical history, male fertility assessment may include, among other things:
New semen analysis
Because sperm quality can vary, it may be necessary to repeat the sample. This gives a more reliable picture than a single sample alone.
Hormonal tests
Blood tests can, among other things, measure hormones such as FSH, LH and testosterone. This can provide important information about how the testicles and the hormonal axis are functioning.
Test for infection
If there are symptoms or specific findings, it may be relevant to test for infection or inflammation.
Ultrasound of testicles
An ultrasound scan may be relevant if there is suspicion of, for example, a varicocele, previous injury, swelling or other changes in the testicles.
Genetic testing
If the sperm count is very low, or if no sperm cells are found in the semen sample, genetic testing may be relevant. This may include, for example, chromosome analysis or testing for specific genetic causes of reduced sperm production.
DNA fragmentation
In selected cases, it is possible to investigate whether a high proportion of the sperm cells have damaged DNA. This may be particularly relevant in cases of recurrent pregnancy loss, repeated unsuccessful treatments or unexplained reduced fertility.
What treatment is best for low sperm quality?
The right treatment depends on how low the sperm quality is.
Insemination (IUI)
Insemination may be relevant if, after preparation, there are enough motile sperm cells for the treatment to make sense. During insemination, the prepared sperm cells are placed directly into the uterus around the time of ovulation.
IVF
In IVF, eggs and sperm cells are brought together in the laboratory so that fertilisation can take place outside the body. This may be relevant for several different causes of infertility.
ICSI
In ICSI, the embryologist selects one sperm cell and injects it directly into the egg. ICSI is often used when sperm quality is clearly reduced, or if there has previously been low or no fertilisation with IVF.
Donor sperm
If sperm quality is very severely reduced, if no sperm cells are found, or if genetic or medical factors make it relevant, donor sperm may be an option. This is a major decision, and it should be made calmly and with good guidance.
The man is not just “the one who provides the sample”
Many men experience fertility treatment as something that mainly centres around the woman. This is understandable – but it can also mean that the man ends up feeling a little on the sidelines.
We do not want that.
At our clinic, we see fertility treatment as a shared journey. The man also needs information, reassurance and the opportunity to ask questions. This applies both to practical questions about semen samples and treatment – and to more personal questions about worries, responsibility, disappointment and hope.
Talk to us about your options
If you are already in fertility treatment, or if you are considering starting treatment, it may be a good idea to have the sperm quality assessed early in the process.
We can help assess which examinations make sense for you, and which treatment best matches your situation.
Book a consultation or contact us if you would like to know more about semen analysis, male fertility or the options available when sperm quality is reduced.